ORIGINAL RESEARCH article
Front. Neurol.
Sec. Headache and Neurogenic Pain
Intra-individual Structural Covariance Network in Patients with Chronic Neck and Shoulder Pain: A Longitudinal Brain Structure Analysis
Tianci Liu 1
Zhiqiang Qiu 1
Jia Ming 2
Mao Jiang Yang 3
Libing He Libing He 1
Hongjian Li 1
Xiaoxue Xu 1
1. Affiliated Hospital of North Sichuan Medical College Department of Radiology, Nanchong, China
2. Affiliated Hospital of North Sichuan Medical College, Department of Pediatrics, Nanchong, China, nanchong, China
3. Affiliated Hospital of North Sichuan Medical College, Department of Pain, Nanchong, Nanchong, China
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Abstract
Background: Neuroimaging studies have suggested that the neural mechanisms underlying chronic neck and shoulder pain (CNSP) are associated with morphological alterations in various cortical regions. However, there is a scarcity of research exploring the structural network characteristics of the brain in patients with CNSP. While most existing studies focus on group-level brain structural networks, there is a lack of insight into individual variability. Additionally, longitudinal studies investigating changes in the brain's structural networks following treatment in CNSP patients remain limited. Methods: To address these gaps, this study enrolled 25 patients with CNSP, obtaining structural brain MRI data and clinical measures before treatment and three months after a minimally invasive intervention. Individual-level structural covariance networks were constructed for each participant to explore structural network differences between CNSP patients and healthy controls (HCs). Longitudinal changes in these networks were also assessed post-intervention. Results: Compared to HCs, CNSP patients exhibited significantly reduced Degree Centrality (P = 0.03, FDR corrected) and Nodal Efficiency (P = 0.0082, FDR corrected) in the right inferior frontal gyrus (pars triangularis), with significant structural recovery observed three months after the intervention. In terms of global network topology, the CNSP group showed decreased small-world properties, specifically in Gamma (P = 0.0093) and Sigma (P = 0.0301) indices; however, unlike local metrics, no significant recovery was observed in these global metrics three months post-intervention. Furthermore, correlation analysis demonstrated a significant negative association between the baseline Degree Centrality of the right inferior frontal gyrus and the percentage change in VAS scores (r = -0.47, P = 0.0168, FDR corrected), suggesting a potential prognostic value. Conclusion: These findings provide valuable longitudinal data that help elucidate the central mechanisms of pain in CNSP patients. They also identify potential biomarkers that could predict the response to minimally invasive interventions, offering insights into individualized treatment strategies for chronic cervical and shoulder pain.
Summary
Keywords
Chronic neck and shoulder pain, graph theory, intra-individual structural covariance network, longitudinal analysis, Minimally invasive intervention
Received
26 October 2025
Accepted
02 February 2026
Copyright
© 2026 Liu, Qiu, Ming, Yang, Libing He, Li and Xu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Xiaoxue Xu
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